Clinicopathological Features And Prognostic Factors Analysis Of Borrmann Type ⅣGastric Cancer

Objective:To investigate clinicopathological features and the independent prognostic factors of long-term survival for Borrmann Ⅳ gastric carcinoma after gastrectomy.Methods:Clinicopathological datas of136patients with Borrmann IVgastric carcinoma from2003.1.1-2011.7.31of tianjin medical cancer hospital undergone gastrectomy were analyzed retrospectively and the survival was estimated using Kaplan-Meier method and compared using Log-rank test and multivariate analysis was determined by Cox regression model.Results:Borrmann Ⅳgastric carcinoma was more common in middle-aged patients with the median age of55years old. The incidence ratio has no obvious difference between men and women. Patients with Borrmann Ⅳ gastric carcinoma presented atypical clinical symptoms, such as discomfort or pain in abdomen. Most patients were at advanced stage at diagnosis, with stage III and IV accounting for40.4%and48.5%of all the cases respecvtively. Using two or more kinds of inspection methods can help raise the diagnosis rate up to100%. Borrmann IV gastric carcinoma was pathologically characterized with the large tumor diameter, the medium of which was about8.7cm, and low degree of differentiation. The disease was prone to distant metastases, commonly involving the liver, pancreas, transverse colon, peritoneum and so on.The1-,3-and5-year survival rates were50.5%,22.7%and15.5%, respectively. The median survival time of these136patients was13months. Univariate analysis showed that T staging,N staging, distant metastasis, TNM staging,tumor size, Postoperative chemotherapy, the curability, the scope of gastric resection, the lymph dissection, extranodal metastasis were related to the prognosis of patients with Borrmann IVgastric carcinoma.(P<0.05). Multivariate regression analysis indicated that only TNM staging, the lymph dissection, the curability, Postoperative chemotherapy, extranodal metastasis were the independent prognostic factors for patients with Borrmann IVgastric carcinoma.(P<0.05)Conclusion:Patients with Borrmann Ⅳ gastric carcinoma were clinically and pathologically characterized by middle-age, concealing early symptoms and advanced stage at diagnosis. Multiple examinations can improve diagnosis rate. Borrmann IV gastric carcinoma had big tumor, lowly differentiated and was prone to distant metastases.TNM staging, the lymph dissection, the curability, Postoperative chemotherapy, extranodal metastasis were the independent prognostic factors for Borrmann IV gastric carcinoma, radical D2or D2+gastrectomy and Postoperative chemotherapy are an effective way to prolong the postoperative survival time in patients with Borrmann Ⅳgastric carcinoma, especially in the early stage.